| NPI | 1760643266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: DE C2-0010103) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: PA OS015148) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: PA OT011625) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: FL OSO11260) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: DE C2-0010103) | |
| 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: DE C2-0010103) | |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2021-04-05 |